TRH is produced from its possible direct precursor, pGlu-His-Pro-Gly (TRH-Gly), by alpha-amidating enzyme. The quantitative response of TRH-Gly-stimulated PRL, TSH, and GH was evaluated in nine patients with anorexia nervosa, six age-matched normal women, eight patients with uremia, five patients with acromegaly, and two patients with prolactinoma. Intravenous injection (500 micrograms) of TRH-Gly caused a 2.6-fold increase in PRL secretion in patients with anorexia nervosa (basal level, 10.0 +/- 1.4 vs. 25.9 +/- 2.5 micrograms/L 15 min after injection; P less than 0.01). In contrast, no significant change was observed in TRH-Gly-stimulated PRL secretion in normal women (basal level, 13.5 +/- 2.3 vs. 15.3 +/- 2.5 micrograms/L 15 min after injection; P greater than 0.05). TRH-Gly did not alter PRL levels in patients with uremia, acromegaly, or prolactinoma. Secretion of TSH, but not GH, was slightly increased by TRH-Gly injection in patients with anorexia nervosa (basal level, 1.41 +/- 0.13 vs. 2.86 +/- 0.22 min/L 30 min after injection; P less than 0.01), whereas no significant secretory response was observed in normal women. These data provide evidence that PRL secretion in anorectic patients is quantitatively different from that in normal persons.